The two-stage orthodontic treatment is a specific procedure to treat malocclusion. This treatment involves space being created to align teeth, correction of habits (thumb sucking, atypical deglutition, …) that contribute to worsen malocclusion and negative morphological and functional changes in the growth of both the jaws and face. The main advantage of the two-stage treatment is the increase of the possibility to achieve healthy, aesthetic and more stable results for good.
STAGE I OF THE TREATMENT
The objectives of the first stage of the treatment include the preservation or creation of space for the teeth, the correction of damaging habits and the achievement of a good relationship between the jaws.
Children sometimes show signs of jaw size problems during growth spurs. An upper jaw and a lower jaw that grow too much or that do not grow enough can be spotted early. When relevant disparity between the jaws is spotted in children above 6 years of age, it means that they may be candidates for an early orthodontic treatment (Stage I).
As children grow quickly, they can greatly benefit from a preventive orthodontic treatment (Stage I) as it is performed with devices to direct the growth of the jaws. This way, the necessary growth will be achieved to provide space for permanent teeth within a balanced bone relationship.
This preventive correction may avoid tooth extraction in the future to correct crowding of the teeth or surgical treatments to align the jaws. When this type of condition is not treated before permanent teeth erupt or before the growth process is completed, then there might be a noticeable difference in the jaw bones that can only be only corrected by an orthodontic device at a later date.
During this period, after Stage I of the treatment, the growth and eruption of permanent teeth are to be monitored. It is recommended to attend regular monitoring appointments and generally use night retainers and space maintainers that enable the eruption of permanent teeth.
FOLLOW-UP OF TEETH REPLACEMENT
When Stage I of the treatment has finished, permanent teeth may not have reached their final position yet. This will be determined and completed in Stage II of the treatment.
In some cases, the selective extraction of some baby teeth are recommended in order to improve the eruption of permanent teeth during the break period. For this reason, it is important to attend follow-up appointments to observe the evolution of teeth replacement (these appointments are normally programmed every six months).
STAGE II OF THE TREATMENT
The aim of Stag II of the orthodontic treatment is to make sure that each tooth has reached its specific place and have aligned with the lips, the cheeks, the tongue and other teeth. Once balance has been established, proper functioning of the teeth is guaranteed.
In this second stage, the treatment can only be orthodontic (exclusively dental movement) or orthopaedic-orthodontic, when bone discrepancies and pending growth stages are found. The second stage of the treatment normally starts with the eruption of all permanent teeth (close to the peak of pubertal growth).
Stage II usually requires a fixed dental device in all teeth for a period of approximately 2 years. Once Stage II has finished, the use of retainers to stabilise results and maintain a wonderful smile will be needed.